Learning from experience: development of a cognitive task-list to assess the second stage of labour for operative delivery
| Autor: | Andrea N. Simpson, Rory Windrim, David Gurau, John Snelgrove, Richard Pittini, Michael B Secter, Ryan Hodges, Eva Mocarski, Mary Higgins |
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| Rok vydání: | 2015 |
| Předmět: |
medicine.medical_specialty
Canada medicine.medical_treatment Physical examination Labor Stage Second Pregnancy medicine Humans Caesarean section Stage (cooking) medicine.diagnostic_test Vaginal delivery business.industry Obstetrics and Gynecology Cognition Problem-Based Learning medicine.disease Delivery Obstetric Surgery Obstetrics Mode of delivery Abdominal examination Female Medical emergency Clinical Competence Educational Measurement Task list business |
| Zdroj: | Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC. 37(4) |
| ISSN: | 1701-2163 |
| Popis: | Objective Ensuring the availability of operative vaginal delivery is one strategy for reducing the rising Caesarean section rate However, current training programs appear inadequate. We sought to systematically identify the core steps in assessing women in the second stage of labour for safe operative delivery, and to produce an expert task-list to assist residents and obstetricians in deciding on the safest mode of delivery for their patients. Methods Labour and delivery nursing staff of three large university-associated hospitals identified clinicians they considered to be skilled in operative vaginal deliveries Obstetricians who were identified consistently were invited to participate in the study. Participants were filmed performing their normal assessment of the second stage of labour on a model. Two clinicians reviewed all videos and documented all verbal and non-verbal components of the assessment; these components were grouped into overarching themes and combined into an integrated expert task-list. The task-list was then circulated to all participants for additional comments, checked against SOGC guidelines, and redrafted, allowing production of a final expert task-list. Results : Thirty clinicians were identified by this process and 20 agreed to participate. Themes identified were assessment of suitability, focused history, physical examination including importance of an abdominal examination, strategies to accurately assess fetal position, station, and the likelihood of success, cautionary signs to prompt reassessment in the operating room, and warning signs to abandon operative delivery for Caesarean section. Communication strategies were emphasized. Conclusion Having expert clinicians teach assessment in the second stage of labour is an important step in the education of residents and junior obstetricians to improve confidence in managing the second stage of labour. |
| Databáze: | OpenAIRE |
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